Diverse association between components of metabolic syndrome and chronic kidney disease in hypertension of different low-density lipoprotein cholesterol levels

Objectives: This study aimed to investigate the association between the metabolic syndrome (MetS) components and chronic kidney disease (CKD) in hypertension of different low-density lipoprotein cholesterol (LDL-C) levels. Methods: This national cross-sectional study was conducted in hospitals in 24 cities of China and comprised of 4792 eligible hypertensive participants with a recorded creatinine level between 2017 and 2018. All participants underwent a clinical survey and clinical assessment and were required to provide biomedical reports within 1 year from their outpatient visit. Student's t-test, log-rank, and Chi-square tests and receiver operating characteristic curve (ROC) analysis were used in data analysis. Results: Participants' average age was 65.82 ± 12.74 years; 54.65% were male. Overall, 52.73%, 63.29%, 26.84%, and 77.27% of participants had a high waist circumference, elevated triglyceride (TG) level, low high-density lipoprotein cholesterol level, and impaired fasting glucose/diabetes, respectively. The adjusted odds ratio (OR) for CKD with MetS was 1.67 (95% confidence interval [CI] 1.32-2.10, P < 0.001). The risk of CKD was associated with older age (OR: 1.05, 95% CI: 1.04-1.06, P < 0.001), female (OR: 1.25, 95% CI: 1.01-1.55, P < 0.001), higher LDL-C level (OR: 1.17, 95% CI: 1.08-1.27, P = 0.03), higher TG level (OR: 1.38, 95% CI: 1.13-1.68, P = 0.001), impaired fasting glucose/diabetes (OR 1.48, 95% CI: 1.2-1.85, P < 0.001), and a combination of two or more than three MetS components (OR: 1.7, 95% CI: 1.07-2.71, P = 0.025; OR: 2.03, 95% CI: 1.08-3.13, P = 0.008, respectively) (ROC curve: 0.7). MetS remained significantly associated with CKD in both LDL-C subgroups, but different associations between the MetS components and CKD were found. Conclusions: MetS and its components are less associated with CKD of LDL-C